Medical fluid management machines are understood here in particular to be devices for conducting, treating and/or distributing fluids and/or gases in which a fluid is transported between a patient and a fluid treatment component and/or a fluid source through a fluid line.
Fluid management machines are understood in particular to also include fluid treatment devices such as blood treatment devices in which a fluid from a patient is sent through a fluid line to a fluid treatment component, is treated by the fluid treatment component and is returned to the patient through the fluid line which may be divided into an arterial branch and a venous branch. Examples of such blood treatment devices include in particular hemodialysis machines. One such blood treatment device is the subject matter of DE 198 49 787 C1 by the present applicant, the contents of which are herewith fully included in the disclosure content of the present patent application.
Dialysis is a method for purifying the blood of patients who have acute or chronic renal insufficiency. A fundamental distinction is made here between methods having an extracorporeal blood circulation such as hemodialysis, hemofiltration or hemodiafiltration and peritoneal dialysis which does not have an extracorporeal blood circulation.
In hemodialysis, the blood is sent in an extracorporeal circulation through the blood chamber of a dialyzer, which is separated from a dialysis fluid chamber by a semipermeable membrane. A dialysis fluid containing the blood electrolytes in a certain concentration flows through the dialysis fluid chamber. The substance concentration of the blood electrolytes in the dialysis fluid corresponds to the concentration in the blood of a healthy person. During the treatment the patient's blood and the dialysis fluid are usually passed by both sides of the semipermeable membrane in countercurrent at a predetermined flow rate. The substances that are eliminated in urine diffuse through the membrane from the blood chamber into the chamber for the dialysis fluid, while electrolytes present in the blood and in the dialysis fluid at the same time diffuse from the chamber of the higher concentration to the chamber of the lower concentration. If a pressure gradient is built up on the dialysis membrane from the blood side to the dialysate side, for example, by means of a pump which withdraws dialysate from the dialysate circulation downstream from the dialysis filter on the dialysate side, water leaves the patient's blood and enters the dialysate circulation by passing through the dialysis membrane. This process of ultrafiltration leads to the desired withdrawal of water from the patient's blood.
In hemofiltration, ultrafiltrate is withdrawn from the patient's blood by applying a transmembrane pressure in the dialyzer without passing the dialysis fluid by the side of the membrane of the dialyzer which is opposite the patient's blood. In addition, a sterile and pyrogen-free substitute solution may be added to the patient's blood. We then speak of predilution or postdilution depending on whether this substitute solution is added upstream from the dialyzer or downstream. The mass exchange takes place by convection in hemofiltration.
Hemodiafiltration combines the methods of dialysis and hemofiltration. There is a diffusive mass exchange between the patient's blood and the dialysis fluid through the semipermeable membrane of a dialyzer, while the plasma water is also filtered out by a pressure gradient on the membrane of the dialyzer.
The methods of hemodialysis, hemofiltration and hemodiafiltration are usually performed using automatic hemodialysis machines such as those distributed by the applicant under the designation 5008.
Plasmapheresis is a blood treatment method in which the patient's blood is separated into blood plasma and its corpuscular constituents (cells). The separated blood plasma is purified or replaced by a substitution solution and the purified blood plasma or the substitution solution is returned to the patient.
In peritoneal dialysis, the abdominal cavity of a patient is filled with a dialysis fluid through a catheter guided through the abdominal wall, said dialysis fluid having a concentration gradient with respect to the endogenous fluids. Through the peritoneum, which functions as the membrane, the toxins present in the patient's body cross over into the abdominal cavity. After a few hours the dialysis fluid in the patient's abdominal cavity is spent and is replaced. Water can enter the dialysis fluid from the patient's blood through the peritoneum by means of osmotic processes, thereby withdrawing water from the patient.
The peritoneal dialysis method is usually performed with the help of automatic peritoneal dialysis machines such as those distributed by the applicant under the brand name sleep.safe.
Dialysis machines as an example of complex medical fluid management machines have extensive functions. To control these functions, medical fluid management machines such as dialysis machines are equipped with at least one control unit. These control units may be embodied as a CPU (central processing unit) or as a microcontroller which is programmed by software programs. Such machines are frequently operated by touchscreen displays. Such a touchscreen display combines an input device and an output device in a single surface, thereby providing a touch-sensitive surface with which operator input can be detected.
Possible alternative embodiments include the spatial separation of the input device and the output device, for example, by a conventional display, for example, as a CRT monitor (cathode ray tube), LCD (liquid crystal display), plasma or OLED display (organic light-emitting diode) as the output device and a touchpad, which is spatially separate therefrom and provides a touch-sensitive surface with which operator input can be detected, as the input device.
Embodiments of a medical fluid management machine are to be described below on the basis of a dialysis machine. Examples of this include infusion devices for medical fluids, cardiovascular support machines with an extracorporeal blood circulation, liver support machines with an extracorporeal blood circulation or the like. Each embodiment which is described below on the example of a dialysis machine as an example of a medical fluid management machine can be transferred readily to another medical fluid management machine. Such embodiments are explicitly covered by the accompanying claims.
Patients suffering from renal failure must regularly undergo dialysis treatments. These treatments are performed in the case of hemodialysis or in general in methods in which the blood is purified in an extracorporeal blood circulation, usually under the supervision of medical personnel in a dialysis unit.
Such dialysis units include several dialysis machines within one room and/or a building so that a plurality of patients can be treated at the same time on these machines.
It is important for the attending medical personnel that the identity of each patient being treated is known and is clearly assigned to a certain dialysis machine. Only in this way is it possible to ensure that the specific patient will receive the treatment intended for him.
For this purpose, there are known patient cards for the individual patient. Such patient cards have at least one interface for communication with a corresponding interface on the dialysis machine and have at least one memory unit in which the individual patient's data can be stored.
The individual patient's data may include the name of the patient. In addition, physiological data such as height, age, gender, normal blood pressure, etc. may also be stored there along with data from past treatments such as the date or duration of the treatment as well as settings on the respective machine such as, for example, the blood flow rate, the dialysate flow rate, the solutions and filters used, etc.
At the start of the treatment, the patient announces himself, for example, by entering the patient card into the dialysis machine. During the treatment, the patient's name may be displayed on the screen on the machine.
The personnel can thus see the identity of the patient at one glance. It has proven to be a disadvantage that knowledge of the patient's name alone does not usually allow an assessment of the patient's medical situation. This requires a knowledge of all the physiological and treatment-related data associated with the patient.
This information is usually not displayed on the screen of the dialysis machine. In addition, there are also known medical fluid management machines which do not display the patient's name.
In addition, other information pertaining to the dialysis machine itself or a treatment performed with it or even the overall situation within a dialysis unit is also important in the past had to be made known in a variety of ways to the persons intended to receive the information.
Such specific data may include, for example: the model, the year built and the service life of the machine, advertising information about the machine, information about the maintenance status of the machine, information about the equipment on the machine and/or about the accessory parts on the machine and optionally also error messages. In addition, it may also be important to obtain information about the occupancy of a dialysis unit, i.e., which people are currently being treated on which dialysis machines, what their current treatment status is, for example, how long the dialysis treatment for each patient currently being treated will last or which patients are intended for a treatment within a certain interval of time in the future.
The information that is to be transmitted will be directed at different people, depending on the informational content. Different people may thus have different types of authorization to receive information output by the dialysis machine or not. For example, information pertaining to the maintenance status or error messages on the machine will be directed at technical personnel, whereas medical data will be sent to medical personnel and should be read only by the latter.
In addition, general information, for example, advertising messages may be directed to a third group, for example, to visitors at a professional exhibition.
The operator of a dialysis machine, in particular the attending physician, may carry with him a device which displays the information intended for that physician, and the data for the corresponding patient may be sent to his device or it may have available an apparatus for input of the patient card in order to get an overview of the patient's medical situation.
Such devices may be devices that are specifically designed for this purpose and are usually portable or there may be conventional mobile computers such as smartphones or tablet PCs, which receive the corresponding data over a data interface. In one embodiment, this data interface is based on wireless communication such as Bluetooth, WLAN or mobile radio technology.